| NPI | 1760017305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY SALVATORE BROCATO Business Manager 985-249-1683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |